Neurogenic Bowel

(Bowel, Neurogenic)

Definition

Causes

The digestion process is partly managed by messages sent between the brain and digestive system. These messages are sent through nerves. When these nerves are damaged, messages between the brain and digestive system are blocked. This prevents the bowels from working properly.

The spinal cord runs from the base of the brain to the lower back. There are 2 main types of neurogenic bowel, depending on where along the spinal cord the damage occurs.

Reflexic Bowel

This happens when there is damage around the neck or chest. Messages between the colon and the brain are interrupted. As a result, a person may not feel the need to have a bowel movement. However, stool is still building up in the rectum. The build-up triggers a reflex causing the rectum and colon to react, leading to a bowel movement without warning.

Areflexic Bowel

This happens when there is damage around the lower end of the spinal cord. When these lower nerves are damaged, a person is unable to feel when a bowel movement is needed. Also, the reflex may be reduced, so the rectum has a difficult time emptying stool. This can lead to constipation.

Risk Factors

Spinal cord injury is the main risk factor.

Symptoms

Symptoms of neurogenic bowel may include:

Trouble having a bowel movement

Repeated bowel accidents

Swollen abdomen

Feeling full (not hungry) quickly

Loose stools or very hard stools

Bleeding from the rectum

Abdominal pain

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. A rectal exam may also be done.

Your waste products may be tested. This can be done with stool tests.

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include:

Bowel Program

Your doctor will work with you to set up a bowel program. This program will help by:

Work with your healthcare team to find an ideal time for going to the bathroom and position to use when having a bowel movement

Participate in other methods to encourage bowel movement, such as doing push-ups, massaging the abdomen, deep breathing, drinking warm fluids, and sitting in a forward-leaning position

Medication

Common medications to treat neurogenic bowel include:

Stool softeners to make bowel movement easier

Colonic stimulants to stimulate the colon to move the stool through the digestive tract faster

Osmotic laxatives to pull water into the intestines to increase stool bulk

Bulk formers to ncrease stool bulk

The types of medications you will take will depend on certain factors, such as the type of neurogenic bowel you have, other medications you may be taking, and your diet.

Digital Stimulation

Digital stimulation is done to encourage movement of the bowels by stimulating the rectum. With this procedure, the doctor will insert a gloved and lubricated finger into your rectum. The will slowly move the finger in a circle. Other types of stimulation include:

Suppositories—stimulate the nerves in the rectum lining

Enemas—stimulate the nerves and soften stool

Surgery

Sometimes surgery may be needed, such as:

Colostomy—An opening is made from the colon to the surface of the body. The opening acts like an anus where solid waste is removed.

Ileostomy—An opening is made from the small intestine to the surface of the body.

Prevention

This condition cannot be prevented. You can decrease the risk of spinal cord injury by taking safety precautions, such as:

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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